opportunities for prevention & intervention in child maltreatment investigations involving...
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![Page 1: Opportunities for Prevention & Intervention in Child Maltreatment Investigations Involving Infants in Ontario Barbara Fallon, PhD Assistant Professor Jennifer](https://reader035.vdocument.in/reader035/viewer/2022070307/551ad0bb55034606048b5154/html5/thumbnails/1.jpg)
Opportunities for Prevention & Intervention in Child
Maltreatment Investigations Involving Infants in Ontario
Barbara Fallon, PhDAssistant Professor
Jennifer Ma, MSWDoctoral Student
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Outline• Introduction to Ontario Incidence Study (OIS)
• Profile of young children and their caregivers in the OIS
• Current service provision patterns
• Intervention opportunities
• Prevention strategies
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Ontario Incidence Study • Core objectives:– Determine rates of investigated and substantiated
maltreatment– Document forms and severity of maltreatment– Examine selected health determinants– Monitor short-term investigation outcomes– Compare rates and characteristics across cycles (93, 98,
03, 08)• Specific to OIS-08– Distinguish maltreatment incident investigations and risk
assessments
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OIS-2008 Sample
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OIS-2008 Sample
* = oversampling provinces
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Methodological Considerations
• Limited to reports investigated by child welfare• Information collected directly from investigating
child welfare workers• No post-investigation follow-up• Not designed to evaluate services• Methodological changes across cycles• Weighted annual estimates, percentages,
incidence of maltreatment
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Home Visiting Programs in Ontario
• Healthy Babies Healthy Children (delivered by Ontario’s 37 public health units)
• Phone calls to every new mother shortly after the baby is born offering information and a home visit
• Screening/assessment for pregnant women, all new mothers, and for families with children up to age six
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Research Literature• Infants are most often referred to a child welfare
agency by professionals, with health professionals being the most common referral source followed by police (Williams et al., 2003; Palusci, 2011).
• Caregiver functioning concerns, including
substance use, lack of social support, parental mental health issues, young parenthood and domestic abuse are risk factors for infant maltreatment (Harden and Klein, 2011; Zhou & Chilvers, 2010; Wu et al., 2004; Putnam-Hornstein & Needell, 2011).
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Study Objectives
• Examine the decision to provide child welfare services to infants identified to the child welfare system using a Canadian provincial data set.
• Identify and understand the importance of key clinical factors in the decision to provide ongoing child welfare services to infants and their caregivers to inform effective practice and policy.
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Child Maltreatment Related Investigations Involving Infants 1993-2008
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Referral Source for Infant Investigations
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Rate of Infant Investigation in 2008
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Type of Child Maltreatment Related Investigations Involving Infants in 2008
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Primary Caregiver Concerns in Infant Investigations
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Child Functioning Concerns in Infant Investigations
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Household Concerns in Infant Investigations
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Summary• 23% of investigations referred from hospitals
• 22% of investigations referred from police
• 21% of investigations referred from non-professional referral sources
• 17% of investigations referred from community or social services.
• 45% of infants are identified to the child welfare system for a concern about their future welfare
• 34% of their primary caregivers were identified as victims of domestic violence
• 42% of households with infants have moved within the past year
• 6% of infants have positive toxicology at birth
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Multivariate Analysis
• Four main types of referrals: hospital, police, non-professional, community or social services
• Classification analysis
• Examining the relationship of clinical predictors to service provision
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Closed 42%Opened 59%
Caregiver Cognitive ImpairmentChi-Square = 18.88***
Noted 24%Not Noted 76%
Closed 9%Opened 91%
Closed 52%Opened 48%
Caregiver Victim of Domestic Violence
Chi-Square = 16.45***
Noted 20%Not Noted 56%
Closed 64%Opened 36%
Closed 18%Opened 82%
Caregiver Few Social Supports Chi-Square = 7.64** Not Noted
38%
Noted 18%
Closed 42%Opened 58%
Closed 74%Opened 26%
Transfers to Ongoing Services Among Hospital Referred Investigations
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Closed 64%Opened 36%
Caregiver Few Social SupportsChi-Square = 4.68*
Not Noted 72%Noted 28%
Closed 70%Opened 30%
Closed 48%Opened 52%
Transfers to Ongoing Services Among Police Referred Investigations
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Closed 57%Opened 43%
Caregiver Drug/Solvent AbuseChi-Square = 9.68**
Noted 24%Not Noted 76%
Closed 29%Opened 71%
Closed 65%Opened 35%
Caregiver Few Social SupportsChi-Square = 6.46* Not Noted 50%Noted 26%
Closed 46%Opened 54%
Closed 75%Opened 25%
Transfers to Ongoing Services Among Non-professional Referred Investigations
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Closed 56%Opened 44%
Caregiver Mental Health IssuesChi-Square = 16.33***
Noted 40%Not Noted 60%
Closed 29%Opened 71%
Closed 74%Opened 26%
Caregiver AgeChi-Square = 9.98**
> 19-21 (36%)< = 19-21 (24%)
Closed 50%Opened 50%
Closed 90%Opened 10%
Transfers to Ongoing Services Among Community or Social Services Referred Investigations
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Conclusion• Large % of risk cases
• Functioning of the caregiver is the strongest determinant of child welfare involvement
• Rapid increase in infant cases speaks to effective early identification of high risk cases and an opportunity to promote caregiver resiliency and prevent maltreatment
• What interventions need to be targeted by whom to these families?
• North American child welfare continues to be driven by case finding, the challenge of providing effective services remains
• Home visitation raises concerns in cases where domestic violence is present